The repair of intrinsic sphincter dysfunction with hypermobile urethra by the laparoscopic Burch–Ball procedure

Treatment of intrinsic sphincter dysfunction in association with genuine stress incontinence has a high surgical failure rate. The Ball modification of the laparotomy Burch colposuspension has been used with a high degree of success by some authors. In the present study, 11 patients were shown to have genuine stress incontinence by transperineal ultrasound, cough stress test, and multichannel urodynamics. Each subject had a hypermobile urethra, an abnormal valsalva leak-point pressure, and a low urethral closure pressure. A laparoscopic Burch–Ball colposuspension was performed and patients were then re-evaluated at 6 weeks and 1 year. There was a 90% objective cure rate at 1 year and the hospital stay and the postoperative recovery time was short. This preliminary study suggests that the laparoscopic procedure is as effective as laparotomy.